Loa loa: development to the infective stage in an American deerfly, Chrysops atlanticus. Chrysops atlanticus, an American species of deerfly collected along the Mississippi Gulf Coast, will support the development of the microfilaria of human Loa loa to the infective stage. Development takes place in the fat body of the fly and requires 9 to 10 days of development and pattern of morphogenesis of the parasite in C. atlanticus is virtually identical to that described in natural African vectors. Chrysops atlanticus will support the development of large numbers of L. loa to the infective stage without apparent ill effects. Two uninfected patas nonkeys each were given 75 third-stage larvae obtained from experimentally infected C. atlanticus. Both animals developed patent infections in approximately 5 months, clearly demonstrating that the entire life cycle of Loa loa can be maintained in the laboratory outside endemic areas.


Influence of serum blocking factors on cancer patients undergoing immunotherapy. Blocking factors are small polypeptide molecules that may appear in the serum of patients with cancer. These factors block the transformation of lymphocytes in culture to nonspecific mitogens such as phytohemagglutinin or concanavalin A and, therefore, may reflect changes in the immunocompetence of the patient. Blocking factors were monitored during the clinical course of thirty-five patients with cancer. These factors did not develop in patients with response to therapy whereas they did develop in patients without response. A third group of patients without response to therapy after a previous remission showed an absence of lymphocyte responsiveness in culture that was not due to blocking factors, suggesting that immune clone consumption had occurred. Dermal responsiveness to tumor antigen correlated with a favorable clinical course and was usually absent when serum blocking factors were present.


Congenital metabolic diseases of pediatric patients: anesthetic implications.


Effects of iproniazid, chlorpromazine and methiothepin on DMT-induced changes in body temperature, pupillary dilatation, blood pressure and EEG in the rabbit. The effects of i.v. N,N-dimethyltryptamine (DMT) were studied on arterial blood pressure, rectal temperature, pupil size and the electroencephalogram of the rabbit. DMT altered these parameters in a dose-related manner causing increased blood pressure, hyperthermia, pupilary mydriasis and activation of the electroencephalogram. Pretreatment with the monoamine oxidase inhibitor, iproniazid, prolonged the effects of DMT, while pretreatment with chlorpromazine or methiothepin attenuated these actions of DMT.


Hydroxyapatite precipitation in vitro by lipids extracted from mammalian hard and soft tissues.


Diffusion fluxes of tritiated water across human enamel membranes.


Structural features of human dental enamel as revealed by isothermal water vapour sorption.


Chondromatous hamartoma of the thyroid gland: report of a case. A case of congenital chondromatous hamartoma of the thyroid gland in a male infant is reported. It presented as a congenital goitre. The thyroid swelling started to increase in size and became hard. It was excised. Histopathological examination revealed the tumour to be a chondromatous hamartoma of the thyroid gland. Reports of this condition in the literature are few.


Torsion of the testis in the newborn.

Torsion of the testis in the newborn. A series of 12 patients with torsion of the testis in the newborn is reported. In all patients the torsion occurred above the investment of the tunica vaginalis. Torsion occurred on the right side in six patients, on the left side in five, and was bilateral in one. The clinical features, operative findings and treatment are described


Antagonisms amongst streptococci isolated from the human oral cavity.


Post-eruptive changes in the fluoride concentrations of human tooth surface enamel.


Mean flow measurements in aortofemoral arterial reconstructions. Eighty-seven limbs in 48 patients have been studied with an electromagnetic flow meter at the time of arterial reconstruction designed to restore blood flow from the aorta to the femoral artery system. The mean overall flow was 339 ml per minute. Blood flow in aneurysmal disease was significantly higher than that recorded in obstructive disease. Blood flow in arteries running into a fully patent femoral system was significantly higher than in those that ran only into the profunda. Age, sex, type of surgery and size of graft had no influence on the flow achieved. Reconstructions for rest pain or advanced trophic change produced flows of the same magnitude as reconstructions for intermittent claudication. The patient's weight correlated significantly with the intraoperative flow. The mean flow in the limbs of 28 patients in whom an accurate preoperative weight was known was 2-56 ml/100 gm/minute, taking the hind limb and hemi-pelvis as 25% of the body weight. This is an acceptably "normal" value. A flow of less than 100 ml per minute in an aortoiliac reconstruction was found to be not likely to result in long-term patency.


An investigation into the prevalence of Streptococcus mutans in Wistar rats, its relationship to the initiation of dental caries, and the effect upon its presence of the diet fed before weaning.


Postoperative complications of thyroidectomy: a comparison of two series at an interval of ten years. A comparison is presented of the complications found in two series each consisting of 331 consecutive patients undergoing thyroidectomy in the same Unit ten years apart. The overall incidence of postoperative complications has been reduced, particularly in the group of patients having thyroidectomy for thyrotoxicosis following which it is now no greater than after thyroidectomy for benign non-toxic goitre. The techniques used to try to reduce the postoperative complication rate are discussed. The incidence of permenent recurrent laryngeal nerve palsy has been reduced to 0-3% and of permanent hypoparathyroidism to 1-2%. The overall incidence of complications causing permanent disability is now 3-9%.


Primary malignant tumours of the mediastinum and their management. Primary malignant tumours of the mediastinum are difficult clinical problems in thoracic surgery from both diagnostic and therapeutic points of view. Three cases of malignant seminoma of the mediastinum have been documented, thus bringing the total number of cases reported in the literature to 78. A case of metastasis to the subcutaneous tissue in malignant thymoma has been documented. Because of the multiple-cell types of these tumours and their ill-defined extent due to involvement of adjacent structures, surgery is often difficult. Radiotherapy along with chemotherapy has a definit place in their management, either as a primary treatment in inoperable cases or as a supplement to surgery if the condition is operable.


The fractured patella: a long-term follow-up study. One hundred and three patients with 104 patellar fractures were examined over a follow-up period ranging from three to 11 years. Patients were assessed subjectively and objectively. The fractures were classified into three groups, transverse, comminuted and polar. Four methods of treatment were used, conservative, internal fixation, partial excision and total excision. In general, the results in the majority of patients were satisfactory, those patients who underwent total patellectomy faring at least as well as any others requiring surgical intervention.


Preoperative irradiation for carcinoma of the bronchus. This paper reports a series of 43 patients with lung cancer treated by means of planned preoperative radiotherapy between 1961 and 1966. A five-year survival figure of 23% is reported for the series. The rationale of the treatment is discussed, together with some clinical situations in which it was felt that this regime had a definite advantage over other methods.


Tropical pyomyositis.

Tropical pyomyositis. Six cases of tropical pyomyositis occurring in Australian, New Zealand and British soldiers in Malaysia and Singapore are described.


Ureterostomy-in-situ.

Ureterostomy-in-situ. A simple operation is described, which in the presence of upper urinary tract obstruction is under certain conditions an alternative to nephrostomy, and which may be modified for use in conjunction with conservative upper urinary tract surgery.


Actinomycosis of bone.

Actinomycosis of bone. Actinomycosis is a rare disease, which is most commonly seen in the cervicofacial region and provides problems in diagnosis and treatment. Cervicofacial actinomycotic osteomyelitis is a curable disease. Its natural history and guides to its management are described.


Experience with the below-knee total-contact cast in the management of tibial fractures. The method of application of the below-knee total-contact cast is illustrated, stressing the importance of firm moulding over the medial flare of the tibia, the popliteal space and the patellar tendon. Forty patients with tibial shaft fractures treated in this manner in Middlemore Hospital during the past four years are reviewed, and a comparison of some features is made with those of forty similar fractures treated in conventional above-knee plasters. The results indicate that a well-applied total contact case controls these fractures adequately and that convalescence is relatively straighforward. In addition, there are obvious advantages to the patient in respect of comfort and mobility.


Focal nodular hyperplasia of the liver: a further contribution. A new dimension has been added to the concept of focal nodular hyperplasia of the liver, in the observation of recent upsurge in incidence pari passu with the use of anovulatory pills. A newly recognized significant surgical feature of the disease is its propensity to serious haemorrhage.


Transglycosylation by the exo-type of beta-N-acetyglucosaminidase from human parotid saliva.


The effect of variations in arterial blood pressure and baroreceptor reflexes on pulpal blood flow in dogs.


Osteogenic replacement of tricalcium phosphate ceramic implants in the dog palate.


Gliomas: a review of an 11-year series.

Gliomas: a review of an 11-year series. A series of gliomas is reviewed in an endeavour to establish the efficacy or otherwise of the various forms of treatment available. In general, it would seem that prognosis depends upon the activity of tumour cells and the anatomical relationships of the lesion. From the experience of this series it appears that wide resection, if this is possible, offers a longer survival time than any other form of treatment.


Giant ureteric calculus.

Giant ureteric calculus. A case of giant ureteric calculus 12 cm in length is reported. Only 11 cases of such calculi measuring 12 cm or more have been previously reported in the literature. The relevant features of giant ureteric calculus are discussed.


IgA and IgG content of the saliva and serum of oral cancer patients.


Malignant parotid cyst.

Malignant parotid cyst. A case of primary malignant cyst of the parotid gland is described, and the possible origins of such cysts are discussed.


Temporo-mandibular joint ankylosis and oro-nasal fistula as complications of facial trauma. Condylar fractures with or without disruption of the temporo-mandibular joint occur commonly with other facial injuries. The subsequent development of ankylosis presents surgical and anaesthetic problems in management and results in severe physical disability to the patient. Oro-nasal fistula is a rare complication of fractures involving the middle third of the facial skeleton, and two cases are reported.


Traumatic pancreatitis and pleural effusion. Two cases of pleural effusion are described, both of which were associated with pancreatitis of traumatic origin. It is suggested that in some cases of unexplained pleural effusion, concomitant pancreatitis should be sought as a possible cause.


The social role of the community psychiatrist in rural Australia: from rejection to acceptance.


Production of, and susceptibility to, bacteriocin-like substances in oral streptococci.


A comparative study of four depression rating scales. Comparisons were made between the overall scores on the Beck, Hamilton, Zung and a visual analogue rating scale in a group of depressed patients. The comparisons were made initially and at one, two and three weeks. Significant correlations between the global scores were found on these depression scales. The value of these scales in clinical research studies in depression is discussed wirh special mention of the value of the visual analogue scale.


Some preliminary observations on a questionnaire technique for classifying depressive illness: its relationship with clinical diagnosis and a biological technique for depressive classification. A questionnaire designed to assist in the classification of depressive illness, was administered to 20 acute depressive patients and 10 normal controls. Patient classification according to the decision rules employed by the questionnaire, were compared with patient classification arrived at by symptomatic (diagnostic) and physiological (G.S.R. inhibition threshold) means. It was found that a preponderance of patients classified as "endogenous depressives" by the questionnaire technique, also had clinical diagnoses of endogenous depression, and had low G.S.R. inhibition thresholds relative to normals. Furthermore a preponderance of patients classified as "non-endogenous depressives" by the questionnaire technique, had clinical diagnoses of neurotic depressive illness, and had high G.S.R. inhibition thresholds relative to normals. This supports the assertion that the questionnaire technique has some validity in the classification of depressive illness.


Psychotherapy and the iatrogenic "love affair". After giving an introductory outline of the phenomenology and theoretical aspects of the concept "love affair", the author proceeds to review a number of symptomatic love affairs arising in the lives of a series of female patients during the course of analytically oriented psychotherapy.. The material is presented in its general aspects and in the form of one detailed case history. In subsequent discussion the author attempts to explain the genesis of these love affairs in terms of phase-speciifc conflicts in the patient and certain iatrogenic aspects of the therapy.


A glycolipid from Rothia dentocariosa.

A glycolipid from Rothia dentocariosa.


Role theory looks at the psychiatrist.

Role theory looks at the psychiatrist.


Ritual prevention in the treatment of obsessive-compulsive neurosis. Behaviouristic theories of obsessive-compulsive neurosis are reviewed and their relationship indicated to the introduction of ritual prevention as a form of treatment for this condition. Studies investigating aspects of ritual prevention are summarised. The treatment of six obsessive-compulsive patients in a psychiatric ward of a general hospital is described and the difficulties encountered outlined. The authors' impression was that the response of patients shown was more marked and immediate than with any other treatment apart from leucotomy.


The effects of discharge on long-stay psychiatric hospital patients. One hundred and forty long-stay patients discharged from Callan Park Hospital were followed up. All except nine were accounted for and 90 who were living outside hospital at the time of the study were interviewed. Thirty percent of the total sample were readmitted during the mean follow up period of 20.4 months. Most of those living outside hospital said that they were happier than when living in hospital. They formed a relatively homogeneous socio-economic group with the majority living in boarding houses and convalescent homes and being unemployed.


Mental health organizations in transition. Many mental health institutions are changing their traditional treatment policies and practices and their organizational structures. Literature is reviewed which provides a model for changing mental health organizations based in general systems theory. The systems organizational model has empirical support in the growing community mental health movement. The strong interaction of technological and ideological factors determining the nature of the new mental health organizations is stressed. Also considered are some of the problems facing those planning and managing changing mental health organizations.


Letter: MANZCP case histories.

Letter: MANZCP case histories.


Out-patient follow-up of those who have attempted suicide: fact or fantasy? 46% of patients who had attempted suicide and were referred to the out-patient clinic of the Royal Adelaide Hospital failed to attend. Similar findings have been reported from other centres. Though it is not known why this is so, tentative speculation is possible. Since it has been shown that persons who attempt suicide are more at risk for suiciding in the future, it seems surprising that their non-attendance has not been more fully investigated.


Letter: Censor-in- Chief's report.

Letter: Censor-in- Chief's report.


Anti-psychiatry, psychiatry, and medicine.


Puerperal psychosis: a follow-up study of a joint mother and baby treatment programme. A cohort of 54 mothers with puerperal psychoses admitted between 1965 and 1969 to a joint mother and baby short stay treatment programme is reported with a follow-up at the end of 1973. The outcomes indicate that this treatment routine is as satisfactory as other programmes. Those who, for various reasons, did not complete the joint programme of treatment did not do so well.


Mental health in isolated new mining towns in Australia.


The two town study: a comparison of psychiatric illness in two contrasting Western Australian mining towns. The results are presented of a survey of patients identified by their general practitioner as having conspicuous psychiatric morbidity, according to Kessel's (1960) Classification, during a three months general practice survey in two Western Australian towns, one Gynalla, a new expanding town in the Pilbara area and the other, Jaburoo, an established economically stagnant town in the South West. The findings show a higher general practice consultation attendance rate for both sexes, and a higher rate of psychiatric illness among females, in Jaburoo than in Gynalla. In Gynalla psychiatric cases among women formed a disproportionately high percentage of all general practice attendances. The implications of these findings are discussed.


Psychotherapy in a large open family group. A technique of psychotherapy is reported, using a large open group of theoretically unlimited lifetime. Family and friends are encouraged to attend and new members are added independently of those leaving the group. Various features of such a group are comparable to small group analysis. The group may be used for the exploration and treatment of family psychopathology. Meetings containing 20 or more members, with several families being represented, are not uncommon. Observers likewise are not limited in number and the group serves a useful teaching and training function as a consequence. A wide range of patients, including those regarded as unsuitable or too difficult for conventional psychotherapeutic management, may be treated by this technique. Illustrative cases are described. The purpose of this paper is to describe a technique of group psychotherapy which has been practised over a period of several years and which differs in some important respects from established methods. This technique, the large open family group, has proven itself to be useful in treating a wide range of patients.


Psychiatric treatment -- its methods and objectives.


Editorial: Control of advertising.

Editorial: Control of advertising.


Letter: The treatment gap.

Letter: The treatment gap.


Letter: Take thought for the morrow.

Letter: Take thought for the morrow.


Influence of hypothalamic hyperphagia on tolerance of lung to explosive decompression. A study was made of the effect of hypothalamic hyperphagia on the tolerance of lung to explosive decompression in male Long-Evans rats. The control and hypothalamic hyperphagic rats were explosively decompressed together from 1 atm to an ambient pressure of 30 min Hg in 0.04s. The hypothalamic-lesiones rats gained from 252 g average weight to 460 g, a 82% gain. The respective figures for the controls. were from 248 g to 336 g and 36%. It was also observed that a considerable amount of fat was accumulated between pleura and lungs in experimental animals. The average accumulation of fat between pleura and lungs in experimental rats was 3.23 g, while the value of the control group was only 0.42 g. The difference was statistically significant. Such an increase of fat accumulation in the thoracic cage could decrease the tidal volume. The severity of decompression-induced pulmonary hemorrages might thus be decreased. On the other hand, it also seems possible that the soft fat cushion between pleura and lungs might damp the bruising of the pulmonary tissue against the resistant thoracic wall to a certain extent, thus resulting in a decreased susceptibility to decompression-induced lung damage. Besides  , the mortality in obese rats undergoing explosive decompression was also significantly lower than that of the controls


Letter: The dentist and prevention of infective endocarditis.


Letter: Caries under composite restorations.


Dental plaque, dental caries and sugar intake. The effects on the plaque of a low-calorie sweetener used in beverages in place of ordinary sugar.


Letter: Aerosol adhesives: a possible hazard?


Fissure sealant treatment. An assessment and follow-up.


The dental treatment of institutionalised mentally handicapped people. A two-year report.


Premolar root perforation by the inferior dental bundle. A case report.


Dental anxiety in children.

Dental anxiety in children.


Women in dentistry.

Women in dentistry.


Influence of leukaemic cells on the colony formation of human bone marrow cells in vitro.


A new translocation associated with the Ph1 chromosome and an acute course of chronic granulocytic leukaemia.


Letter: Possibility of pre-selection of patients for prognosis in acute leukaemia.


Adenosine deaminase activity in leukaemia. Adenosine deaminase (EC 3.5.4.4., ADA) has been measured in the blast cells of 36 patients with acute lymphoblastic, acute myeloid, chronic myeloid and chronic myeloid blast crisis leukaemia. Particularly high levels were found in acute lymphoblastic and chronic myeloid blast crisis patients. The measurement of ADA may be useful diagnostically in the undifferentiated acute leukaemias and in detecting the early onset of blast crisis in chronic myeloid leukaemia. Possible reasons for the elevation of ADA in malignant cells are discussed.


Letter: Increased serum iron in acute leukaemia.


Sexual problems in disorders of the nervous system. I. Anatomical and physiological aspects.


Growth rate of pulmonary metastases in human sarcomas. The growth rate of spherical pulmonary metastases was studied in 15 patients with osseous and soft tissue sarcoma. The median volume doubling time (Dt) was 25 days. The time from diagnosis of the primary tumor to occurrence of pulmonary metastases correlated directly with the length of Dt. No correlation between Dt and tumor histology was observed. The effect of therapy on the tumor growth curve was studied in 1 patient. The therapeutic implications derived from the quantitative evaluation of tumor growth rate are discussed.


Treatment of acute leukemia in adults.

Treatment of acute leukemia in adults. Improvement in the management of acute leukemia in adults has not progressed nearly so rapidly as has the treatment of childhood leukemia. One important difference is that most adults have myeloblastic or related forms of the disease (AML), whereas the majority of children have lymphoblastic leukemia (ALL). However, even adults with ALL fail to respond as well to a similar regimen as do children with the same type of leukemia. In a recent series of patients with ALL who were treated with the complex multiple drug "L-2" protocol, the incidence of complete remission in adults was 78% vs. 99% in children, and the median duration of remission was only 24 months in the adults, whereas it has not yet been reached in the children and is projected to be over 4 years. In AML and the related nonlymphoblastic forms of acute leukemia, therapy is still unsatisfactory in both adults and children. With the best current drug treatment schedules, the incidence of complete remission is now better than 50%, but it is often difficult to compare the exact remission rates in different series because of differences in reporting results. In adults treated with the multiple drug "L-6" protocol, the incidence of remission in previously untreated patients was 56% and the median duration of remission was 10 months. The median survival of all patients (responders and non-responders) was 1 year whereas that of responders only was 2 years. It is encouraging that a significant proportion of those patients with AML who have complete remissions now remain in remission for extended periods; about 45% of patients responding to the "L-6" protocol remained in remission over 1 year, and 18% have been in continuous remission for 2 to over 4 years. Even after discontinuing treatment, some patients with AML stay in remission for long periods, and it is possible that some of them may have been cured. If this proves to be true, it becomes of great importance to determine what is different about the patients who do exceptionally well as compared to the majority who continue to die within a year. However, no consistent nor distinctive favorable prognostic features have yet been identified.


Antigens shared by leukemic blast cell and lymphoblastoid cell lines detected by lymphocyte-dependent antibody. Lymphocyte-dependent antibodies (LDA's) directed against antigenic determinants present on lymphoblastoid cell lines as well as human leukemia blast cells were demonstrated in heterologous antisera obtained by immunizing rabbits with a membrane fraction from RPMI-4265 (a lymphoblastoid cell line derived from a patient with chronic myelogenous leukemia). LDA was present at high titers against B-lymphoblastoid, myelomonocytic, and stem cell lines. The T-lymphoblastoid cell line MOLT-4, however, did not react. LDA was demonstrated against acute myelogenous as well as lymphoblastic leukemia cells. The reactivity was not directed against phytohemagglutinin-induced blastoid antigens, fetal antigens, or fetal calf serum. Absorptions with lymphoblastoid cell lines removed all LDA reactivity. Similar results were obtained by absorbing the rabbit antiserum with acute lymphoblastic and/or acute myelogeneous leukemia cells. These findings indicate the presence of cross-reactive antigens between lymphoblastoid cell lines and leukemia cells. Furthermore, cross-reactivity between acute lymphoblastic and acute myelogenous leukemia cells was demonstrated.


Combined use of levator retrodisplacement and pharyngeal flap for congenital palate insufficiency.


Speech results after Millard island flap repair in cleft palate and other velopharyngeal insufficiencies. Twenty-four patients were evaluated for voice quality after primary palatal repair by the Millard island flap procedure. In patients with overt cleft palate, acceptable speech was obtained in 71 percent. In patients with velopharyngeal insufficiency without an overt cleft, the success rate was 60 percent. Although we consider this method reliable and useful, we have no reason to believe that it offers substantial advantages over other established procedures. We suggest that the main reason for our failures to achieve velopharyngeal competence and acceptable voice quality after a repair is the inherent hypoplasia of palatal musculature.


Location of the levator veli palatini insertion following levator retropositioning, palatal pushback, and pharyngeal flap procedures. A long-term cineradiographic follow-up study of twenty patients with velo-pharyngeal incompetence fails to demonstrate predictable retrodisplacement of the levator insertion following combined levator retropositioning, pushback, and pharyngeal flap procedures. Simple levator retropositioning gave posterior displacement in the two patients evaluated. Patients with normal or posterior levator insertions pre-operatively all demonstrated post-operative anterior displacement following pharyngeal flap procedures, either alone or in combination with pushback. Anterior levator displacement may be the result of scar contraction or division of the levator sling (during insetting of a pharyngeal flap). Pre-operative and post-operative speech evaluation demonstrated substantial improvement in all except 3 patients; 2 of the poor speech results were patients with demonstrated levator retrodisplacement on post-operative cineradiography.


A review of the results of two different surgical procedures for the repair of clefts of the soft palate only. This study evaluated results of the two surgical procedures for repair of cleft palate. Simple closure using the Von Langenbeck technique was compared with the V-Y retroposition technique as modified by Wardill and Kilner. The population consisted of two groups of children who were similar in chronological age and intelligence and for whom surgery was performed at an average age of 1 year, 11 months, in the simple closure group and 1 year, 8 months, in the V-Y repair group. In the early pre-school years, the children were evaluated in the areas of intelligence, language, hypernasality hearing, articulation, and voice quality. The two groups were found to be roughly similar in intelligence, language, and articulation at that time. The simple closure group was at first found to be slightly more hoarse than the V-Y repair group while the latter was found to have slightly more hypernasality. Hearing acuity was somewhat poorer in the simple closure group. The final evaluation was carried out when the mean chronological ages were 10 years, 1 month, for the simple closure group and 10 years, 2 months, for the V-Y repair group. Included in the second assessment were measurements of intelligence, language, articulation, nasal resonance, hoarseness, nasal emission, hearing, and velopharyngeal closure, The groups were judged to roughly comparable in intelligence, language, articulation, hypernasality, nasal emission, and velopharyngeal closure. A difference between groups occurred in regard to hearing acuity where the simple closure group showed slightly more hearing loss. This group was also judged to have more hoarseness. In regard to velopharyngeal closure, it was noted that all subjects in both groups had mechanisms of adequate or borderline efficiency. However, the children in the simple closure group compared as well as they did with the V-Y retroposition group only after 27 per cent had had secondary procedures as compared to 11 per cent in the V-Y repair group...


Radioautographic study of chondrocytic proliferation in nasal septal cartilage of the 5-day-old rat. Relative rates of chondrocytic proliferation in the 5-day-old rat nasal septum are determined radioautographically, using tritiated thymidine as the labeling agent. The results are tabulated and charted graphically; they show that the zone of greatest activity is the portion just anterior to the septoethmoidal junction. The area of second highest activity is the antero-superior tip of the septum. All other regions are either relatively inactive or show only sporadic areas of proliferative activity.


Two dimensional ultrasonic demonstration of lateral pharyngeal wall movement in real time--a preliminary report. Preliminary observations are reported in three normal subjects using a multi-element, ultrasonic transducer unit for demonstrating in real time and two dimensions the movements of the lateral nasal and oropharyngeal walls during phonation. Ultrasonic images produced are similar to those seen on frontal roentgen motion recordings. Present limitations, potential applications and advantages of this technique are discussed.


Incidence and type of otologic disease in the older cleft-palate patient. Cleft lip and palate patients, 16 years and older, selected at random, were studied to determine the type and frequency of middle ear disease. Various morphologic and physiologic factors interrelating to cleft form and otopathology are discussed.


Sociological aspects of cleft palate adults: IV. Social integration. The patterns of social integration of adults with primary and secondary groups were evaluated for 196 adult cleft subjects, their 190 siblings and 209 random controls. Results indicated that cleft adults tended to rely on the extended family for mutual aid and social activities. They also participated less frequently in voluntary associations and relied on a few one-to-one friendships. Social activities tended to be that of informal visiting patterns. While it would be inaccurate to characterize the cleft adult family as grossly different from other American families, they are a definable population experiencing some degree of limitation associated with having a cleft.


Current concepts of treatment of ear disease in cleft palate children and adults. This author had demonstrated that the incidence of conductive hearing loss in adults who have had cleft palates approximates 50%. That their ear disease arises during infancy has been well documented by Stool and Paradise. The serous otitis media which develops in infancy and persists through adolescence is presently best treated by tympanic aeration tubes. Whether or not a limited adenoidectomy is a useful adjunct in treatment remains to be conclusively demonstrated. That cleft palate repair and/or pharyngeal flap surgery is helpful in the eventual outcome of ear disease would seem to be so. The end product of recurrent serous effusions and/or ear infections can be a chronic draining ear and/or cholesteatoma which following the attainment of adolescence is best treated by mastoid tympanoplasty with ossicular reconstruction. The effect of hearing on the speech of palate patients is discussed and a new method for using visual cues in helping palate patients speak less hypernasally offered.


A family with oculodentodigital dysplasia. Three members of a family present definite features of the oculodentodigital (ODD) dysplasia and one presents only a few features. The mother shows no clinical evidence of the syndrome but does have an isolated cleft of the palate. The syndrome is compatible with Mendelian autosomal dominant inheritance with father-to-son transmission. The variable expression of the gene in the three affected members is clearly demonstrable.


Chemotherapy of osteosarcoma.

Chemotherapy of osteosarcoma. Recent advances in the use of chemotherapy for treatment of osteosarcoma have altered out pessimism in this disease. Results are presented from 3 groups of investigators using different agents as adjuvant chemotherapy following immediately upon amputation of the primary. The Roswell Park Memorial Institute began a regime, immediately after amputation, of adriamycin 30 mg/M2 for 3 doses and given every 4-6 weeks. This study was subsequently expanded in a cooperative group (ALGB) and the results on 20 patients analyzed. At 19 months approximately 75 per cent are free of any pulmonary metastases compared with 10-25 per cent expected from amputation alone. Similar results have been obtained by other Centers using different chemotherapeutic agents. In Boston Children's Hospital high dose Methotrexate with citrovorum factor is used. In 12 of these patients local control of the primary by surgery was obtained and of these only 1 developed pulmonary metastases during an observation time of 23 months. At the M. D. Anderson Hospital multi-drug combinations were used including Cyclophosphamide, Vincristine, L-Phenylalamine Mustard and Adriamycin. They reported a survival rate of 55 per cent (10 out of 18). All of these neoplastic agents have toxic side effects but when carefully used these effects are minimized and the quality of life is quite good. Many questions must be answered by future controlled long term follow-up studies.


Editorial: Osteosarcoma.

Editorial: Osteosarcoma.


The implications of "skip" metastases in osteosarcoma. A prospective study of 40 consecutive classic primary osteosarcomas employing tomography, angiography, radio-scanning, tetracycline labelling, macroscopic and microscopic study revealed that in 10 (25%) "skip" metastases were found. In 8 the "skips" were completely unsuspected prior to computation. It is evident that patients with "skips" are more prone to local recurrence and have a worse prognosis following amputation than those without such satellite lesions. Through-bone amputation entails a considered risk of leaving micro-foci of tumor; proximal disarticulation does not obviate the risk of cross joint "skips" when the lesion is in a sub-articular site. What affect such residual foci has upon the effectiveness of adjunct therapy and conversely whether such therapy will permit more conservative surgery by suppressing residual "skips" is an important but unanswered question.


The surgical management of primary osteosarcoma. Regrettably amputation remains to the present day an essential part of treatment in osteosarcoma of the limb bones. Only by its inclusion in the therapeutic regime can the present best level of about 20 per cent survival be achieved in any large group of patients. Preliminary biopsy is essential and there is no evidence that it is harmful even if followed by a delay of many days before definitive treatment. In patients treated initially by radiotherapy, selective amputation some 6 months later only in patients free of metastases, carries just as good a prognosis for the group as a whole as initial primary amputation in all patients. This method, first described by Cade, is widely practiced in the United Kingdom and spares many patients who develop early metastases following initial radiotherapy from unnecessary mutilating surgery shortly before inevitable death. Local recurrence may follow retention of a femoral stump following amputation for osteosarcoma at the most common site in the lower femoral metaphysis. There are cogent arguments in favor of hip disarticulation in such patients although they do not include evidence of greater survival. The balance between the two procedures is finely drawn but is weighted in favor of disarticulation.


The host immune response in human osteosarcoma. A patient's immunologic response to a malignant tumor may be a major factor in determining his ultimate prognosis. An in vitro microcytotoxicity test using cultured tritiated thymidine (3HT) labeled osteosarcoma cells and autologous fibroblasts has been developed to determine the nature of this response. The role of cell mediated and serum factors has been quantitatively evaluated and the following results obtained. Osteosarcoma patients have been demonstrated to possess a normal cellular immune response which exhibits non-specific cytotoxicity in vitro. These patients can not differentiate their tumor cells from autologous fibroblasts, even though they may significantly suppress the growth of homologous tumors or fibroblasts. Serum blocking factors capable of inhibiting lymphocyte mediated cytotoxicity are occasionally noted. A reliable quantitative microcytotoxicity technique is presented which demonstrates that: (1) osteosarcoma is not due to host immuno-incompetence, (2) a common sarcoma antigen does not exist and (3) serum blocking factors may occasionally be present.


Osteosarcoma. Results of treatment employing adjuvant immunotherapy. The treatment of patients with osteosarcoma continues to result in few survivors despite advances in surgery and radiotherapy. Since the primary site of failure is pulmonary, it is apparent that a systemically active adjuvant must be employed if a cure is to be achieved. Because of the experimental evidence for an immune response against osteosarcoma and because of the potential systemic activity of the immune system, a trial of postoperative adjuvant immunotherapy was begun. Seventeen patients received immunotherapy consisting of BCG and an allogeneic tumor cell vaccine following surgical removal of all gross tumors. Eighteen per cent (3/17) of the patients who received immunotherapy remained alive and free of disease compared to 0/12 who did not. An analysis of the 14 patients with recurrence, revealed that the median time to recurrence was 3.0 months in both groups. It is, therefore, apparent that at the time of initiation of immunotherapy subclinical metastasis must already have been present. Therefore, on the basis of this study we conclude that adjuvant chemotherapy should be employed to further reduce the tumor cell burden in order for immunotherapy to be effective for osteosarcoma.


DNA-RNA hybrid in cells infected by murine leukemia virus.


Mechanism of induction of RNA tumor viruses by halogenated pyrimidines. Frome these studies on JLS V-9 cells, a number of conclusions can be drawn about the mechanism of MuLV induction by halogenated pyrimidines. The compounds can induce virus from otherwise healthy cells as long as deoxycytidine is present along with the inducing agent. The compounds must be present during the S phase of the cell cycle and must be incorporated into DNA in order to induce virus (Teich et al. 1973). Only one strand of DNA need be substituted by BrdU or IdU in order to induce virus, because a one-hour period of incorporation leads to induction. From these results it is possible to construct a model for how halogenated pyrimidines are able to induce viruses from otherwise uninfected cells. Because the critical period for the incorporation of the compound is a restricted segment of the S phase of the cell, there would appear to be a critical segment of the genetic information of the cell which, when substituted with BrdU or IdU, leads to a transcriptional derepression. Presumably the critical segment of DNA is either a controlling element of the integrated provirus or it is a separate gene which controls the expression of the integrated provirus. Whichever is true, these results strongly imply that the search for specific repressors of the segments of mammalian DNA is likely to be successful and that RNA tumor viruses may offer a system in which such repression systems can be identified and investigated.


Cleavage maps of DNA from adenovirus types 2 and 5 by restriction endonucleases EcoRI and HpaI.


Cell transformation: a study of regulation with types 5 and 12 adenovirus temperature-sensitive mutants.


Genetic analysis of human adenovirus type 5 in permissive and nonpermissive cells.


RNA synthesis and processing in adenovirus-infected cells.


Mapping of adenovirus 2 RNA sequences in lytically infected cells and transformed cell lines. The strands of the six EcoRI fragments and the HpaI fragments E and C of Ad2 DNA were separated by electrophoresis in agarose gels. Using 32P-labeled fragment strands in solution hybridization experiments, the fraction of each strand complementary to RNA extracted from infected or transformed cells was assayed by chromatography on hydroxylapatite. In this manner, a tentative map of the cytoplasmic RNA sequences has been constructed for viral RNA extracted from cells both early and late during infection (see Fig. 16; in the map shown, the two strands of Ad2 are named the r and l strands following the bacteriophage convention). Since early cytoplasmic RNA anneals to four distinct regions of the genome, Ad2 probably codes for at least four early gene functions. Summation experiments have shown that all RNA sequences found in the cytoplasm of cells early during infection are also present in the cells' cytoplasm at late times. Viral RNA sequences in five independently isolated and cloned transformed rat cell lines were also mapped on the Ad2 genome. One class of Ad2-transformed rat cells contains RNA sequences complementary to only the segment of Ad2 DNA from 0.03-0.10 on the physical map, and this corresponds to one of the four regions of the genome expressed early during infection. If a viral gene product is necessary to maintain the transformed phenotype of the cell or codes for the virus-specific tumor (T) antigen, this genetic information must be at the left end of the genome (see Fig. 16). The two other classes of Ad2-transformed rat cells contain viral RNA sequences complementary to two or three of the regions of the genome transcribed into early cytoplasmic RNA. At both early and late times during the lytic cycle, the nucleus of the infected cell contains viral RNA sequences that are not transported to the cell's cytoplasm, suggesting that RNA processing and selection may play a role in the regulation of viral mRNA production.


An examination of the nuclear RNA of adenovirus-transformed cells.


RNA transcription in cultures productively infected with adenovirus 2.


Integration of adenovirus DNA into the cellular genome.


The viral DNA replication machinery of adenovirus 12. The viral DNA replication complex was found in the M band after fractionation. However, it did not associate with the nuclear membrane, but was found in association with types II and IV inclusions. It is suggested, therefore, that the viral DNA replication complex is the inclusions types II and IV. The analysis with Ad12 ts mutants showed the involvement of three viral genes in initiation of viral DNA replication, in formation of the viral DNA replication complex and the inclusions types II and IV. Temperature sensitivity of the gene products involved in viral DNA replication was also examined. From the data presented, the following sequence of viral DNA replication in Ad12-infected cells is suggested: (1) Synthesis of a protein (gene A product), which may be an acceptor or may modify the nuclear constituent to be an acceptor for parental viral DNA, to form the viral DNA replication complex; (2) synthesis of a protein (gene B product), which may be required for the parental viral DNA to associate with the acceptor and to form a type II inclusion-like structure (precursor of type II inclusion?); (3) synthesis of a protein (gene C product), which may be required for activation of the complex or type II inclusion and to alter type II inclusion to type IV inclusion. Further studies are necessary to substantiate the suggestion.


The transcriptional role of host DNA-dependent RNA polymerases in adenovirus-infected KB cells. From the present experiments, we can conclude that late in infection two classes of DNA-dependent RNA polymerase transcribe the viral genome. Although we cannot definitively exclude the possibility that one or both of these enzymes are coded for by the virus, it appears more probable that these are hos enzymes, because of the coincidence of the alpha-amanitin sensitivities for synthesis of specific viral RNAs with the toxin sensitivities of the respective host RNA polymerases. Furthermore, the chromatographic properties of the enzymes, the alpha-amanitin sensitivities of the purified RNA polymerases and the levels of solubilized activities are the same for uninfected and late infected cells. It seems probable that some virus-coded or virus-induced factor(s) modifies either the selectivity or the activity of these host RNA polymerases. As an example, the "inactivation" of RNA polymerase I activity in vivo or the increased endogenous activity of isolated infected cell nuclei, without changes in the solubilized level of the respective RNA polymerases, could be mediated by such factor(s). The effect of such factors may not be detected by activity measurements on exogenous DNA, because it acts as a nonspecific template. Analysis of such factors will require reconstitution of appropriate in vitro systems, which retain some transcriptional specificity. Since several viral mRNAs synthesized at late times (Tal et al. 1974) and the 5.5S RNA (J. Pan, pers, comm.) are transcribed from the same region (R-R1 restriction enzyme fragment A), initiation and termination signals for both RNA polymerase II and III are contained in this portion of the genome. Further studies of the interaction of these two enzymes with the adenovirus 2 genome should contribute to understanding the control of transcription in eukaryotic cells, in particular in the case of virus-infected or -transformed cells.


The mechanism of replication of adenovirus type 5 DNA. The analysis of replicating Ad5 DNA has led to a model for replication involving linear intermediates. The origin of replication has been localized at the molecular right end, suggesting the presence of a unique sequence of nucleotides which can be recognized by an initiation factor. On the other hand, the study of the molecular ends has shown, so far, a high degree of symmetry in the terminal nucleotide sequences of Ad5 DNA. A more detailed study of the nucleotide sequences at the ends is necessary to solve this problem.


Origins and termini of adenovirus type 2 DNA replication.


Early events in adenovirus-infected cells.


Analysis of adenovirus type 2 gene functions by cell-free translation of viral messenger RNA.


The origin and destiny of adenovirus proteins.


Analysis of multiple viral genome fragments in adenovirus 7-transformed hamster cells. The presence of multiple copies of a portion of the viral genome was demonstrated in Ad7-transformed cells by a new method based on the kinetic analysis of labeled viral DNA reassociation in the presence of unlabeled transformed cell DNA. DNA-DNA homology measurement utilizing defined DNA fragments (restriction endonuclease digests) as labeled probes supported the above conclusion.


Virus-like particles in acute lymphoblastic leukaemia: ultrastructural findings.


Recent studies on the characteristics of adenovirus-infected and -transformed cells.


Introduction to heavy metal toxicity, safety and hormology.


Toxicology of non-radioactive heavy metals and their salts.


The dental profession, the community, and the hospital.


Hormology with inorganic compounds.

Hormology with inorganic compounds. Three components of the dose-response reaction, usually seen as three separate curves, are reviewed as a single continuum of the effect of the dose of any agent upon an organism. The usual considerations of any agent in toxicology are the harmful actions. The individual considerations of an essential nutrient or of a hormone usually suggests a positive action. The third component is the stimulatory action as understood in hormone research and as seen in many studies with minute doses of toxic materials. The coelescence of these concepts into one continuum gives a broad viewpoint which is helpful to understand the biologic implications of any toxic, nutritious or stimulating material under a variety of conditions. Such a view is useful in predicting results and in understanding the reaction of living organisms to their environments; when small amounts of a chemical are added to a biologic system, one parameter may be affected in one way and another parameter in the opposite manner. Consideration of the complete dose-response curve led to the concept of hormology, the sutdy of excitation. The thesis of hormology is that any harmful agent may be stimulatory for any parameter when it is administered in subharmful quantities to an organism existing in a suboptimum environment. Concepts fro hormology allow the suggestion that the zero equivalent point (zep) could be used to replace zero tolerance as a practical, legislative concept for dangerous chemicals in our environment. A reivew of three pharmacology texts revealed four types of dose-response curves. The alpha curve demonstrated a simple toxicity, the beta curve exhibited a single stimulation peak followed by a toxicity as more material was added; the gamma curve showed an initial harmful reaction followed by a stimulatory reaction which, in turn, was followed by a toxic reaction as the quantity of material administered was increased; and the delta curve was essentially a sign wave in which two peaks of stimulation were separated by a "harmful valley", then, as greater concentrations of material were administered, toxicity was noted. A brief review of agents which are stimulatory in minute doses showed that a considerable amount of work had been done with radiation and late work has established emf as a stimulatory vehicle. Little work is done with other physical agents. Organic chemical compounds are known to be stimulatory in small quantities; e.g. dietary antibiotics. The fact that antibiotics stimulate growth in germfree animals and the fact that nongermicides stimulate classic animals proves their direct effect on the animal tissues.


Inhibition of protein synthesis in reticulocyte lysates by double-stranded ribonucleic acid extracted from nuclei of leukemic cells.


Administrative structure of an accredited hospital. The administrative structure of an accredited hospital is defined by the Joint Commission on Accreditation of Hospitals. It includes a governing board that represents the community, an executive committee that is responsible for patient care activities and is supported by standing committees, and a hospital administrative unit consisting of a chief administrator and numerous assistants. Policy recommendations are received by the governing board from the executive committee and must be approved by the board. Problems are resolved through a joint conference committee made up of representation from the executive committee and the board, as well as participation by hospital administrators. Finally, the medical staff is divided into departments that assume responsibility for patient care within their disciplines, as well as determine the awarding of credentials to applicants for hospital privileges.


Ambulatory hospital dentistry.

Ambulatory hospital dentistry. The scope of outpatient hospital dentistry is broad and embraces a full range of patient care as well as education and investigative activities. The ambulatory dental service provides an ideal setting for the care of medically compromised patients and treatment requiring a multidisciplinary approach. The hospital dental staff and administration are especially well qualified to bring dignified, high quality, total health care to patients and educational programs to the profession. These factors are paramount in formulating a strategy for meeting the future health care needs of our population.


Inpatient hospital dentistry.

Inpatient hospital dentistry. Inpatient hospital dentistry has been reviewed. The expanding role of the hospital as a focal point for dental treatment of the healthy as well as medically compromised patient has been emphasized. A portion of this article has been devoted to admission and discharge procedures for the dental inpatient. The hospital chart is seen as the only instrument and record of the patient management and thus the various parts of the chart have been outlined. A review of the common laboratory tests useful to dentist and physician alike is included in this section. It is hoped that the material contained herein will serve as a guide to the general dentist or specialist who may utilize the hospital to admit patients.


Student-hospital-school. A new amalgam.

Student-hospital-school. A new amalgam.


Pain control--the team approach.

Pain control--the team approach. The most important factors involved in administering sedation and anesthesia to patients undergoing dental treatment are good preoperative evaluation, a well equipped facility with all necessary equipment not only for the safe administration of drugs but also for resolving complications that may ensue, and a team of experts capable of working together smoothly and able to deal with any emergency. This care is possible in the office situation; however, we believe it is only achieved at great expense and with the underutilization of equipment as well as personnel. It may be, therefore, that the best way to achieve this goal is for dentists and anesthesiologists to work together in the hospital environment. Hopefully, an ever increasing number of dentists will be joining the staffs of hospitals so that these objections may be achieved simply and with maximal utilization of equipment and personnel.


The dentist in the operating room.

The dentist in the operating room.


Commonly used hospital abbreviations.

Commonly used hospital abbreviations.


The proposed international terminology for the classification of congenital limb deficiencies.


Von Gierke's disease: a case report.

Von Gierke's disease: a case report.


Skeletal changes in leukemia in children.


Some laboratory studies on the accuracy of bite mark comparison. Bite marks in wax and in pig skin were compared with study models of the subject making the bite. Photographs, impressions and measurements of the bites were used. Bites in wax could be readily identified especially if measurements were made on photographs but identification from bites in non-vital pig skin was more unreliable. It is suggested that similar difficulties may be encountered in the assessment of bites in human skin. Expert witnesses involved in presenting evidence on bite marks in a court of law should be aware of the difficulties of making valid comparisons even under standardized laboratory conditions. Further studies to improve and substantiate the reliability of the technique are clearly required.


A hotel fire.

A hotel fire. A hotel fire in Copenhagen claimed 35 victims of eight different nationalities. An account is given of some major aspects of the dental identification work, including a few case reports. This disaster became professionally important because the dental expert team was allowed a completely free hand. Eight dental experts cooperated closely in recording, photographing and radiographing dental conditions in the victims and thereby became able to establish that, with adequate facilities at hand, complete dental registration of a single victim required an average of three man-hours. Three of the experts subsequently cooperated in establishing comparable antemortem data on the known missing persons, in comparing the ante- and postmortem data sets, and in completing the necessary paper work. Here, it could be shown that a further two man-hours were required per victim. In a final report to the police it was proposed that---in any future case---such number of dentists should be assigned which, allowing three man-hours per victim, would enable the dental team to finish the oral autopsy of the given number of victims within five full working days, i.e. a minimum of two dentists per 30 victims. Two dentists will accomplish complete recording in less than half the time it will take any dentist working single-handed to finish it, so that the question of cost can hardly become an obstacle. It remains for the profession to make sure that an adequate number of knowledgeable dental experts are always available.


A new approach to the basic principles of endodontics. The basic principles on which successful endodontic therapy depends have been commonly accepted as (1) debridement, (2) sterilization and (3) obturation. Each of these principles is subjected to critical evaluation. Because of the morphological complexity of most root canals complete debridement is not possible. No sampling technique is yet available to ensure total sterility of the prepared root canal nor is it possible to ensure that the root canal system is hermetically sealed by the filling material. Although it has been shown that 43 per cent of biopsies from the periapical area of endodontically involved teeth show evidence of cyst formation, the fact that up to 90 per cent of cases show evidence of healing following endodontic treatment without surgery indicates that radicular cysts can resolve without surgical intervention. In the light of these findings it is suggested that the basic principles should be accepted as (1) adequate debridement, (2) adequate obturation and (3) trephination where indicated.


Dental care of the special patient in the hospital environment. In this new era, where the emphasis in dental care is gradually moving in the direction of the patient, as differentiated from the former emphasis on the teeth and the mouth, the 'special patient' can and should receive the type of total dental care he or she deserves. The environment of the hospital, and all that the hospital brings with it to the patient care environment, makes the facilities for special patient care better and allows patients who were formerly seriously neglected to receive much the same attention as so-called normal patients. The group of special patients considered includes the physically handicapped, institutionalized or home-bound chronically ill, those with psychiatric disturbances and the mentally retarded as well as the hospitalized patient. One example of a hospital dental service conducted as a group practice is described in some detail. Advantages of this pattern of practice to the participants include the availability of conferences and clinics, access to a broad range of patient experience and the possibility of further study in specialized hospital activities. For the patient, total dental care is available throughout the 24 hours. Each patient is normally assigned to his or her own dentist, but is referred to another member of the group when special skills are needed.


There are no two cases alike.

There are no two cases alike. A number of routine cases are reviewed: 1. A skull with a canine porcelain crown nicely glued in line was considered a study object, not a case of actual forensic interest (Fig. 1). 2. A murder victim was identified as a certain young girl; records including radiographs and plaster models showed no inconsistencies, but at least 28 concordant traits, among them characteristics in a root-filled central incisor (Fig. 2). 3. The body of a young suicide could be identified by means of one intraoral radiograph taken prior to one extraction, the only treatment listed in his dental record (Fig. 3). 4. After a fire, an unmarked rubber denture was found among debris; it showed burning along the distal palatal edge, so could not have been in the mouth of the owner during the fire. Being so completely deformed, it had to be discarded as evidence. 5. Another denture, removed from the mouth of a victim of the same fire, showed typical burning of the frontal parts, but also a stripe of burning along the midline (Fig. 4); accordingly, this victim must have inhaled flames before he died. 6. An old woman disappeared; in her home, police found an unmarked full lower denture left behind on her bed. When recovered dead several months later, this woman carried a full upper denture but no lower. Dental experts were not involved in this case but later saw both dentures; they had been made at different times and occluded badly. Did this woman have two sets? Or did the lower denture maybe originate from her murderer? The author urges that the FDI design an international system of denture marking. 7. A man was found murdered with an axe; police experts had reason to believe that he might have been executed somewhere else, but tooth 12 (Fig. 6)---found lying loose under the head---showed marks which proved that it had been exarticulated by one of the axe blows (Fig. 5). Consequently, the recovery site was also the execution site.


Clinical application of the I.B.M. cell separator.


Community attitudes to home treatment of mental patients.


Conjoint hospitalisation of mother and baby in post-partum syndromes - why and how.


An interdisciplinary programme for family planning among North African families in the developmental towns of the Negev.


Technical variations in the psychoanalytic treatment of a preschool child.


Obsessive psychosis -- a cross-validation study.


Potentially harmful child-rearing practices.


Advances in the treatment of osteogenic sarcoma.


Amputation in osteosarcoma.

Amputation in osteosarcoma.


Ewing's tumour. A study of behaviour and treatment in forty-seven cases. Forty-seven histologically confirmed cases of Ewing's tumour are reported, with typical age, sex and skeletal distributions. The disease-free survival curves are like those for osteosarcoma of corresponding types of bone, but with higher mortality. The two-year disease-free survival rates were 24 percent for tumours of long bones and 5 per cent for those of other bones. Osseous metastases were most frequent, although the lung was the commonest single site involved. There were secondary deposits in lymph nodes in nine patients, possibly also in four more with mediastinal enlargement. Although initially radiosensitive, one-third of tumours recurred locally, almost always with the appearance of metastases. Neither whole bone irradiation nor high dosage alone ensures complete control of the primary tumour, and it is suggested that recently reported improved results of treatment should be attributed to adjuvant multi-drug chemotherapy. Inadequate control of the primary tumour diminishes the chance of survival and for some sites radical operation merits reconsideration.


Osteosarcoma in children. A study of 125 cases. A study is presented of the aetiology and results of treatment in a group of 125 proven osteosarcomas present in children under fifteen years of age. These cases have been collected from the records of one English and six European treatment centres. There is a slight male preponderance, but the striking aetiological feature is the very high proportion of tumours of the long bones of the limbs (96 per cent). The two and a half and five year disease-free survival rates were respectively 15 and 12 per cent, with a further 9 per cent still living, but under observation for less than two and a half years. Evidence of metastasis after two and a half years is very unusual, but no child with a tumour of an axial or girdle bone lived this length of time. Although the differences in the results of the different methods of treatment employed are not statistically valid, the largest number of long survivors had been treated by early amputation, which method also provided the lowest rate of local tumour recurrences. Reasons are discussed which indicate that prompt ablation is the treatment of choice, perhaps with certain advantages in the light of recent advances in adjuvant treatment. The past situation in connection with childhood osteosarcoma certainly provides strong support for immediate carefully designed clinical trials of the new adjuvant methods cited.


Monostotic Paget's disease of the mandible.


External forces causing tooth movement: a case report.


Introducing a clinical flavour to prosthetic technique teaching.


Implant assessment.

Implant assessment.


Cytofluorometric studies on the action of podophyllotoxin and epipodophyllotoxins (VM-26, VP-16-213) on the cell cycle traverse of human lymphoblasts. Flow microfluorometric analysis of human lymphoid cells exposed in vitro to cytostatic concentrations of podophyllotoxin (0.01-5 mug/ml for 24 h) shows that a major part of this population (40-60%) has the DNA content of cells in the G2-M part of the cell cycle, and that approximately 60% of these cells are arrested in mitosis. Although a similar pattern of DNA distribution is seen in cultures exposed to cytostatic concentrations of VM-26(0.01 mug/ml) and VP--16-213(0.1 mug/ml), no mitotic cells are seen in these cultures. Exposure to higher concentrations: of VM-26 (0.1 mug/ml) and VP-16-213 (1.0 mug/ml) inhibits cell cycle traverse, and after 24 hr of exposure a major part of the population is arrested with the DNA content of cell in the S part of the cell cycle. Exposure to higher drug concentrations leads to a reduction in the number of cells with the late S-G2DNA content. Whereas the cell cycle block induced by cytostatic concentrations of podophyllotoxin (0.01 mug/ml) is readily reversible by reincubation of cells in drug-free medium, cells blocked by VM-26 and VP-16-213 are unable to resume cell-cycle traverse under similar conditions.


Determination of lead in toothpastes.

Determination of lead in toothpastes.


"Perforated palate" in a 15-month-old baby: a case report.


Porous calcium sulphate dihydrate as a biodegradable implant in bone.


Variations in microbial and biochemical components of four-day plaque during a four-week controlled diet period. Variation in microbial and biochemical components of human four-day plaque was studied in seven subjects who were maintained on a high-sucrose diet during a four-week period. Significant changes in populations of lactobacilli dextranase-producing organisms, Streptococcus mutans, and S sanguis occurred during this period.


An epidemiologic study of deciduous molar relations in preschool children. This study indicated that distoclusion decreased significantly with age and was more prevalent in siblings of children with Class II molar relation as compared with the prevalence for the total population. Children of middle socioeconomic status (SES) and girls with Class I molar relation had prevalences of posterior crossbite significantly greater than lower SES children and boys, respectively. Finger habits were highly associated with posterior crossbite (P less than 0.001).


SNA and SNB angles in a population of Nubian schoolchildren. The descriptive statistics for the sella-nasion-A point (SNA) and sella-nasion-B point (SNB) angles computed from a sample of Nubian schoolchildren are presented, by age and sex, and compared with the analogous statistics for American Caucasian schoolchildren.


Occurrence of haemophili in dental plaque and their association with neuraminidase activity. The mean concentration of haemophili in 31 specimens of plaque was 1.23 times 10(6) per milligram or approximately 4.4% of the viable bacteria present. Occurrence of different species was similar to saliva with Haemophilus parainfluenzae constituting 87.8%. Most haemophili produced neuraminidase and appeared to be primarily responsible for the small amounts of this enzyme in plaque.


Impedance of amalgam-dentin interface in cat tooth. The impedance between two amalgam electrodes implanted in the maxillary canine of a cat was measured at various frequencies between 0.02 kilohertz (kHz) and 100 kHz. When plotted on the X-R plane as a function of frequency, two types of impedance loci were obtained. One resembled a circular are at low frequencies, whereas the other was parabolic or exponential in formmthe circular-arc loci are similar to those calculated from membrane models. The parabolic or exponential loci are predicted by a polyelectrolyte model.


Polymerizable amines as promoters of cold-curing resins and composites. The accelerating activity of N,N-substituted aminoethyl methacrylates on the curing of methyl methacrylate and composite resins with benzoyl peroxide is somewhat smaller than that of dimethyl-p-toluidine. Tesins cured with aminoethyl methacrylates containing a p-tolyl and 3,5-xylyl substituent on the nitrogen atom turned approximately the same color in ultraviolet light as resins cured with dimethyl-p-toluidinemthe incorporation of the predominant part of an unsaturated tertiary amine into polymer chains reduces to a minimum the possibility of its diffusion from the resin into the surrounding tissue.


Use of filmed modeling to reduce uncooperative behavior of children during dental treatment. Sixteen inner city children attending a pedodontic clinic were shown either a filmed demonstration of a child model cooperatively undergoing dental treatment or a film unrelated to dental activity. The group viewing the modeling film showed significantly fewer disruptive behaviors during restorative care and were rated as less fearful than the control group.


Localization of bacteria on the rat tongue with scanning and transmission electron microscopy. Scanning microscopy of rat tongue showed that bacterial habitation of the tongue was almost completely localized to the middle third of the anterior surface of the filiform papillae. Transmission microscopy showed coccal forms attached to the surface of the epithelium by means of fibrillar strands and present up to four cell layers deep within the epithelium.


Analysis of stress patterns in the human mandible. Replicas of a dentate human mandible were prepared in photoelastic resin material. They were positioned in a supporting frame by means of struts, representing the principal muscles of mastication. Occlusal loading was simulated, and the stresses generated within the models were examined by three-dimensional photoelastic stress analysis.


Dentist's ratings and adolescents' perceptions of oral health. The extent to which adolescents' self-appraisals of dental status agree with the dentist's evaluation is analyzed. The dentist's evaluation was expressed in standard dental status indicators (DMF, OHI-S, Russell Index) and in a rating of overall status as "excellent," "good," "fair," "poor." The relationship between the adolescents' self-reported dental care practices and the dentist's evaluation is also examined.


Role of attrition and occlusal contact in the physiology of the rat incisor: IX. Impeded and unimpeded eruption in lathyritic rats. In the rat, the administration of a lathyrogenic agent reduced both impeded and unimpeded eruption rates of incisors. Unimpeded eruption rates were greater than impeded eruption rates. The general eruption pattern in the experimental rats was, however, similar to that in the control rats. Thus, eruption was possible even in rats with a lathyrogenically impaired periodontal ligament.


Investigation of possible solvents for extracellular polysaccharides from Streptococcus mutans and Streptococcus sanguis. The solubilities of extracellular polysaccharide fractions produced by 14 oral streptococcal strains were compared in water, aqueous lithium and guanidine salt solutions, dimethyl sulfoxide (DMSO), and a 9:1 DMSO-water mixture. The best results for solubilizing the fractions were obtained with the DMSO-water mixture procedure, which used the water and DMSO in sequence. By this method all fo the fractions were solubilized.


Reproducibility of the electromyogram.

Reproducibility of the electromyogram. Electromyographic recordings of masseter muscles were taken during mastication without the introduction of an experimental variable. The amplitude, duration, and sequence of the onset of muscle bursts were used to evaluated the recordings. Amplitude showed the most variation during the same session, at different sessions, and between three different areas of the masseter muscle. Onset showed the least variation during the same session and at different sessions; duration showed the  least variation between areas.


Effects of dietary sucrose levels on the quantity and microbial composition of human dental plaque. The effects of dietary sucrose levels on the microbial composition of 4- and 12-day plaque were investigated in eight dental students. Sucrose-rich diets had no demonstrable effects on total plaque accumulation, whereas total viable microbial density, Streptococcus mutans, and the lactobacilli populations increased. The S sanguis population was unaffected. However, in individual subjects, an inverse relationship between the S sanguis and S mutans population was observed.


Failure of rabbit anti-Streptococcus mutans serum to penetrate in vitro plaque. An indirect fluorescent antibody technique indicated that specific antiserums did not penetrate in vitro plaque formed by Streptococcus mutans. Specific reactions did occur between the antiserums and antigens in the surface layers of plaque globules. Measurements of plaque diameters indicated that the serums exerted a nonspecific effect of enhancing plaque growth.


Effects of dietary sucrose levels on extracellular polysaccharide metabolism of human dental plaque. The effects of increased and low dietary sucrose levels on the biochemical activities and composition of 4- and 12-day plaque were investigated in eight young men. The subjects were fed supervised, nutritionally adequate diets. Dextran hydrolase, levan hydrolase, and total carbohydrate content were increased during a sucrose-rich diet while invertase activity was decreased. Base-extractable carbohydrate was decreased in four-day plaque during the sucrose-rich diet. Glucosyltransferase and fructosyltransferase activity, buffer-soluble carbohydrate, and buffer-soluble protein were also determined.


Dose-dependent ultrastructural changes induced by tetracycline in developing dental tissues of the rat. Tetracycline was administered to rats in varying doses in order to study the likelihood of ultrastructural alterations to ameloblasts and to study odontoblasts and dentin as well. The changes caused by tetracycline to the mineralization of dentin and the ultrastructural changes to the odontoblasts and ameloblasts increased with larger doses.


Residual fluoride concentrations and scanning electron microscopic examination of root surfaces of human teeth after topical application of fluoride in vivo. Fluoride concentrations in root surfaces of human teeth after a single topical application with a 2% acidulated sodium fluoride solution in vivo were investigated. Increased residual fluoride concentrations in the root surfaces and precipitations on the peritubular dentin, as revealed by SEM micrographs, may be factors in reducing hypersensitivity.


Electrophoretic patterns of parotid fluid proteins from caries-resistant and caries-susceptible individuals. Parotid saliva samples from caries-resistant and caries-rampant individuals were electrophoresed on polyacrylamide gel slabs. The parotid saliva of the caries-rampant group showed a significantly higher level of anodemigrating proteins, predominantly isoamylases, and a significantly lower level of cathode-migrating proteins than that of the caries-resistant group in both paraffin-stimulated and sour lemon-stimulated salivary flows.


Editorial: The private dental schools--an uncertain future.


Electromyographic investigations of the tongue and circumoral muscular sling with fine-wire electrodes. The electromyographic (EMG) examination of 11 normal individuals in whom bipolar fine-wire indwelling electrodes were placed showed no EMG activity during rest periods and only very slight to slight activity during normal oral functionsmduring aberrant oral activity, such as thumb-sucking, the orbicularis oris and genioglossus muscles gave a marked EMG response and the buccinator muscles were slightly active. These findings may help explain the classical malocclusions seen in tongue-thrusters and thumb-suckers.


Frequency of dental trait anomalies in cleft, sibling, and noncleft groups. The incidence and types of dental trait anomalies found in individuals with cleft lip or cleft palate or both (cleft group), in siblings of the cleft group, and in a group of individuals without cleft lip or cleft palate (noncleft group) were compared. The cleft group had 1.02 anomalies per individual, the sibling group, 0.38; and the noncleft group, 0.17. The frequency of occurrence of thick-curved maxillary central incisors, incisal fissures, and missing teeth were significantly different among the three groups.


Educational needs of dental faculty members.


Student participation in community dental health programs: the experience at SUNY at Buffalo.


MIND--a five-state regional approach to continuing dental education. MIND has finished two years of operation as a regional center for continuing dental education. The responses from viewing cards, and the number of credit hours given, indicate that approximately 20% of the potential audience participated in the course offerings. Previous experience from a two-year study in South Dakota has shown that there are three major factors that are essential for effective use of television as a dissemination medium. These are as follows: 1) the program should establish effective use of the communication system to maintain an audience; 2) the quality of thr programming material that is televised must be high; 3) the program should be televised on a regular basis to develop viewer habits or expectations. With a potential audience of 11,000 persons, MIND has had to depend heavily on a bulk-rate mailing system to communicate with members of the dental profession. This has caused problems such as reminders not being received on time, or being lost in the mail, or not being read, so that the individual is unaware that the courses are being telecast. Another problem of mailing system is maintaining an up-to-date list of addresses. The names and addresses of the dental assistants are impossible to keep up to date. We use the lists of licensed dentists and dental hygienists issued each July and a list of the certified dental assistants, which, of course, does not include all the dental assistants in our five-state area. A system providing more direct contact with the individual needs to be developed. Quality of televised courses is determined by the clinician's style of presentation as well as by the content and organization of the course material. The selection of dental information aimed toward the dentist in general practice results in loss of some members of the viewing audience, particularly specialists and generalpractitioners who have confined their practice to a particular area of dentistry. Quality is also judged by the technical aspects such as camera coverage, color, types of audiovisual materials, and televison reception. There is a limited amount of videotaped material available, and the members of the Board of Directors are asked to preview the videotapes and select three courses that they judge to be of the best quality for the year's programs. One difficulty is to find courses that will be of value to all three groups--dentists, dental assistants, and dental hygienists. Despite the problems encountered, the use of educational television should focus on the positive characteristics of availability, relatively low cost of operation, and the opportunity to provide continuing dental education at a convenient time and place.


A survey of extramural experiences for dental students. A survey was conducted of the chairmen of the departments of community dentistry (or an equivalent department) within all full-curriculum dental schools in the United States as of September 1973, to obtain information on the rane of extramural experiences, the departmental responsibilities for these experiences, the times and the distributions of the experiences, and on feedback related to the experiences. Thirty-six respondents reported a wide variety of experiences with most activities under the auspices of departments of community dentistry. A trend toward concentration of the extramural experiences in the latter years of the curriculum was noted. Feedback from both the participating dental students and the patients was mostly positive to strongly positive. Most responding chairmen agreed that the extramural experiences may be helping to create a more socially conscious graduate, although few had conducted formal evaluations of the programs which could support this impression.


Continuous-progress education: III. Student self-evaluation and peer evaluation.


Apparent modulus of elasticity of dental amalgams.


Direct effect of radiation on the solubility of human teeth in vitro.


Characterization of esterase from mouse submandibular gland.


The dental nurse program in Singapore.

The dental nurse program in Singapore.


Radioautographic study demonstrating 3H-fucose uptake into cultured rabbit palates at the time of palate fusion.


Adhesive and sealing properties of gallium alloy.


Editorial: Evaluation of clinical quality and professional performance.


Plastic replicas as three-dimensional models of pulps. It has been found that the plastic models significantly enhance the student's knowledge of the anatomy of teeth as it relates to operative dentistry. The fact that the models are three-dimensional eliminates guesswork as to the exact position of the pulp, and the rigidity of the plastic cast enhances the recovery of morphological features of the pulp as it existed in the natural tooth.


Expanded roles for the dentist.

Expanded roles for the dentist.


Near-constant methacholine-induced parotid flow in the dog.


Detection of oxygen in corrosion products of dental amalgam.


In vitro study of the effect of GK-101 on the removal of carious material.


Microhardness of human apical cementum related to fluoride exposure and age.


A method of quantifying the number of faculty members a dental school needs.


Teaching basic dental concepts to medical students.


Practical considerations of a flexible course in a nonflexible curriculum. In the context in which this course was conducted, i.e., flexibility within an otherwise rigid curriculum, and no deadlines, several conclusions can be drawn: 1. Students used considerably more time than when the course was traditionally structured. 2. Quality of performance in the preclinical laboratory was significantly better. 3. Students took longer to complete the laboratory requirements than didactic requirements. 4. Some reasonable deadlines are necessary. 5. Student and instructor attitudes favored flexibility.


Levan formation by whole cells of Actinomyces viscosus ATCC 15987.


Method to investigate bioelectric regeneration of bone in periodontal defects.


The dental assistant extern program within the hospital dental service--its need and implementation.


Orthodontic development supervision of the growing child.


Variations in tooth dimension and geographic caries prevalence.


Financial record-keeping simulation in the dental auxiliary utilization clinic. A financial record-keeping and billing simulation program which is part of the Dental Auxiliary Utilization (DAU) didactic and clinical experiences has been reported. Evaluation of student performance has demonstrated a satisfactory level of accomplishment. The students' performance may reflect their awareness regarding the importance of understanding the management of the financial affairs of a dental practice.


A course on behavioral skills and the psychological aspects of dentistry.


Dental caries in preschool Apache Indian children.


Letter: Conclusion in article potentially detrimental.


Editorial: Letters to the editor: the purpose in publishing them.


The postponed revolution.

The postponed revolution.


Letter: Follow directions.

Letter: Follow directions.


Letter: Solution on reciprocity.

Letter: Solution on reciprocity.


Letter: A simple solution to continuing education.


Letter: Continuing education editorial brings pro and con comments.


Letter: Dental service in a hospital.

Letter: Dental service in a hospital.


Letter: Defend root canal measuring accuracy of Sono-Explorer.


Letter: Caution and restraint.

Letter: Caution and restraint.


Letter: Extraction and hostility.

Letter: Extraction and hostility.


Letter: Integrity of manufacturers.

Letter: Integrity of manufacturers.


Letter: Proper access, preparation key endodontic factors.


Licensure: facing the real problems.

Licensure: facing the real problems.


The issue of reciprocity.

The issue of reciprocity.


ADA Public Education Program: reviewing 1975 and anticipating 1976.


Institute of Medicine: a brief look at a controversial body.


Human pulp response to acid pretreatment of dentin and to composite restoration. The newer composites, although free of methacrylic acid and of a neutral pH, were still found to be toxic to the pulp. The intensity of response was increased after acid pretreatment procedures; this indicates an increase in dentin permeability. When the remaining dentin thickness was 1.0 mm or less, regardless of whether the dentin was primary dentin or primary and reparative dentin, the percentage of teeth with abscess formations increased. Use of calcium hydroxide bases or liners to coat the dentin before acid pretreatment of enamel is therefore highly recommended.


New light on the transmissibility of viral hepatitis in dental practice and its control. Evidence of an increase in the nonparenteral spread of viral hepatitis is of much concern in dentistry and supports the need for sterilization of all instruments used in intraoral treatments. Methods for the rapid sterilization of all dental handpieces and air-water syringes are still inadequate for routine clinical use. It may be possible to improve surface disinfection of these items by more thorough, repeated cleansing with common disinfectants and by the use of stronger germicidal agents such as aldehydes. However, for handpieces and some other equipment, effective sterilization methods must be developed or the instruments must be modified so they can be safely and rapidly sterilized. Surface disinfectants that will destroy hepatitis viruses are needed for disinfection of the dental unit. The use of gloves is also an important consideration for the protection of both the dentist and his patient. The high attack rate of hepatitis among surgeons, as well as patient protection, make the wearing of gloves during surgery imperative. Evidence that aerosolborne viruses would be removed by filtered laminar air flow or by face masks is not available, but use of these devices reduces exposure of personnel to aerosols in general and appears to be highly desirable. Sterilization of all possible instruments is advocated for use in all institutions and dental offices. Careful monitoring of the effectiveness of sterilization also is advocated. These concepts and new information on which they are based should be incorporated into dental curriculums and continuing education courses for all dentists and auxiliary personnel.


A quantitative comparison of services performed for fee-for-service and capitation patients. The numbers of specific services performed for fee-for-service and capitation patients were compared in a group dental practice. The capitation patients received more services per 100 patients in almost all categories. This is attributed to the incentives for the dentist and a lower out-of-pocket cost for the patient.


Dental malpractice: a problem for some. Council on Insurance.


Dental caries after radiotherapy of the oral regions. Five cases of dental caries after radiation therapy of the oral regions for treatment of carcinomas are presented. The differences in clinical appearance and behavior between radiation caries and ordinary smooth-surface dental caries are described. The role of salivary gland irradiation and the resultant xerostomia in the development of these lesions is discussed. Some explanations are offered as to how these lesions develop in the light of current knowledge concerning plaque and the development of dental caries. Several measures that may be taken to reduce the incidence and severity of these lesions are suggested.


American Dental Association standard for dental terminology. Council on Dental Materials and Devices.


Laboratory and clinical evaluation of the radiation-potentiating activity of ethyl-N-bis (2,2-dimethylethylamidinophosphoro) carbamate (AB-132). Ethyl-N-bis (2,2-dimethylethylamidinophosphoro) carbamate (AB-132) has been shown to potentiate the effect of whole-body radiation on inhibition of splenomegaly induced by Friend leukemia virus in ICR/H Swiss mice. The combined effect of AB-132 and radiation does not appear to be related to Friend virus inhibition but seems to act on the proliferating tumor in the spleen. Nine children with advanced cancer were treated with combined administration of local radiation and systemic AB-132. Although regression of tumor was seem, no dramatic effect on survival was apparent. One case of metastatic Ewing's sarcoma showed systemic tumor response to AB-132 in addition to localized response to radiation. Bone marrow depression appeared to be the main side effect of combination therapy.


Loss with age in the capacity for erythrogenin production by extrarenal tissues in rats. Erythrogenin levels in liver and spleen were compared in young and adult anephric rats exposed to 6h of hypoxia. Hepatic and splenic erythrogenin levels in young nephrectomized rats were significantly higher than those in anephric adults. This lowered ability of the adult rat to elaborate extrarenal erythrogenin may be related to a decrease in selective enzyme production which accompanies the aging process.


Implanted amniotic membrane as an autograft and as an allograft. Detailed studies on autograft and allograft amniotic membranes implanted in the subcutaneous tissues to form tunnels are described. Autograft amniotic membranes appear to become permanent structures whereas allografts of this material, though accepted by the host for a longer time than most allografts, were eventually rejected. Serial histological studies were performed.


Effect of N6-(delta2-isopentenyl)adenosine treatment in vivo on hexokinase activity of mouse L 1210 cells. The kinetic properties of hexokinase of L1210 ascites tumor cells propagated in DBA/2HaD mice are altered by treatment of the mice with the modified nucleoside N6-(delta2-isopentenyl)-adensone (IPA). Relative to animals not treated with IPA, ascites cell hexokinase showed an increased affinity for ATP and a decreased affinity for glucose as a result of IPA treatment. The heat stability of the enzyme was different in treated and untreated mice. It was concluded that IPA treatment may either produce changes in enzyme conformation which resulted in a change in control mechanisms or may induce the formation of a hexokinase isoenzyme.


The significance of lymphocytosis in congenital hypoplastic anemia. Two infants with congenital hypoplastic anemia had an unusual number of lymphocytes in their peripheral blood and in the bone marrow. This caused an erroneous diagnosis of acute lymphocytic leukemia to be made in the first case and inappropriate therapy to be administered for three months. The second of these cases provided an unusual opportunity to study human erythrocyte precursor dynamics. Serial bone marrow aspirates, obtained after institution of treatment with a corticosteroid, revealed an initial increase in labeled lymphocytes, a concomitant decrease in their number, and the subsequent appearance of erythroid elements. These findings suggest that cells classified morphologically as lymphocytes may serve as erythroid precursors in human beings.


Prognostic factors in childhood leukemia.


Results following three modalities of periodontal therapy. Three methods for treatment of periodontal pockets (subgingival curettage, modified Widman flap surgery, and pocket elimination) were applied as a clinical trial to 82 patients. Follow up results over one to five years after the initial treatment are reported. The variations in attachment levels and pocket depth were analyzed statistically as related to methods of treatment and yearly time intervals following the initial treatment. The most favorable results regarding gain or maintenance of attachment levels and reduction of pocket depth were observed interproximally. Subgingival curettage provided the greatest gain in attachment level up to three years postoperatively, but after four to five years there was no significant difference in results following the three methods. The most significant loss of attachment and return of pocket depth occurred on the buccal aspects of the teeth, and the results were not significantly different for the three methods except at the first year of follow up when the attachment level was maintained best after curettage.


The effect of bicuspid extraction orthodontics on the periodontium. Findings in 100 consecutive cases.


Mucogingival problems, prevalence and therapy in children. The clinical impressions of the authors and a survey of mucogingival problems in children lead to the following conclusions: 1. Mucogingival problems occur in children. 2. The prevalence of such problems is 12 to 19% in sample of 100 patients examined. 3. Insufficient keratinized tissue is developmentally related to: a. eruption pattern of the permanent incisors. b. buccolingual width of the alveolar process. 4. The autogenous free gingival graft is recommended as an acceptable procedure to prevent incipient mucogingival problems from progressing. 5. Where orthodontic therapy is anticipated and coincidentally insufficient keratinized tissue exists, a free gingival graft should be performed prior to tooth movement. 6. Grafts would be recommended in children with 1 mm or less of keratinized tissue. 7. Grafts would not be recommended in children when there is over 2 mm of keratinized tissue. 8. Grafts would not be recommended in children with greater than 1 mm of attached gingiva.


Occlusal characteristics and tooth mobility in periodontally healthy young males classified orthodontically. Three groups of periodontally healthy young males classified as to orthodontic status by the Handicapping Labio-Lingual Deviations Index were evaluated for various occlusal characteristics. A much larger proportion (95%) of the orthodontically normal subjects (Group I) had an Angle Class I type of occlusion than the Group II subjects requiring orthodontic care (60.5%), or the Group III subjects who had received orthodontic care (63.4%). The percentages of subjects with a "cuspid-protected" type of occlusion were larger in the orthodontically normal and orthodontically treated groups than in the group requiring orthodontic care. Anterior displacement of the mandible in closing from centric relation to the intercuspal position was found in the majority of subjects in each group. Displacement of more than 2 mm was most common in the subjects requiring orthodontic care. Only 1 of the 41 orthodontically treated subjects reported that his occlusion had been adjusted by grinding after tooth movement. There were no statistically significant differences in mean tooth mobility values between the orthodontically normal and orthodontically treated subjects. The lateral incisor tooth had a significantly lower mean mobility value in subjects whose orthodontic care included removal of the first premolar than in subjects treated without removal of the first premolar. Wear facets were common in all three groups. Based on the findings, one can conclude that orthodontic therapy was only partially successful in obtaining the objectives described as part of an ideal result. It should be noted, however, that the status of the dentition and occlusion prior to orthodontic treatment could not be determined for more than a few subjects.